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VOLUME 81 NO. 4
AUGUST / SEPTEMBER 2023
14
8
THE PUBLIC HEALTH SYSTEM
State government offers 4 per cent
As The Lamp goes to print, the Ministry of Health and the NSW state government have put forward their final offer in response to our log of claims.
16 THE VOICE
First Nations members seek representation
The NSWNMA has embarked on a path towards representation and leadership for Aboriginal and Torres Strait Islander members within the Association.
18 THE VOICE Closing the gap on infant mortality
Birthing on Country programs aim to engage Aboriginal and Torres Strait Islander women in effective antenatal care.
20
NURSE PRACTITIONERS
Nurse practitioner reforms provide a career boost for nurses
The federal Labor government is making it easier for patients to use nurse practitioners – and boosting career prospects for registered nurses.
24 SOCIAL JUSTICE
Be bold and hold corporations to account on tax, government told
The NSWNMA has raised concerns about federal government hesitancy on draft legislation that would combat tax dodging by multinational companies.
COVER STORY
Two big steps forward for aged care
The aged care sector has taken two historic steps towards better staffing and decent wages for nurses and other employees.
REGULARS
5 Editorial
6 Competition
6 Your letters
28 Branch Beat
30 What’s on
32 Ask Shaye
37 News in brief
46 Your Health & Wellbeing
The momentous win by our aged care sector members will change the picture for all nurses, but only if we remain engaged and forward thinking.
A special day for our union occurred on 1 July. It was a historic moment. Over the last few months we have rightly celebrated the achievements of our aged care members, who have fought hard and bravely to lift their sector out of the abyss it found itself in during COVID-19 and onto a path of renewal and sustainability.
Finally, the rewards of that struggle have started to become real, with the 15 per cent pay rise beginning to flow through to members and the introduction of RN 24/7 from 1 July (see p. 8).
Like all great historical achievements these are not merely events; they are milestones in a process that started a long time ago and will continue for some time yet.
But the rewards are now tangible and there are more to come. It is a welcome start.
These wins were hard won and their implementation and the ongoing improvements that are still needed in the sector to provide the care elderly Australians deserve require us to keep fighting.
The majority of employers are complying. But we know there will be some that won’t. It would be naïve to think otherwise. It is our job to keep these employers honest.
The consequences of better pay and better care in aged care will also be felt in the public health sector and in private hospitals.
They will bring genuine competition into the health workforce. Aged care employers could be paying more than those in the public health system and private hospitals. It means nurses will have choices. It will create pressures and challenges in these other areas but will also provide opportunities.
We shouldn’t underestimate the significance of that.
If employers in any sector want to be able to attract and retain nurses, they are going to have to raise their game in terms of remuneration, conditions of work and standards of care. It will be healthy competition that we welcome – a race to the top.
Already we are seeing signs that private hospitals have recognised this new reality.
One example is at Chris O’Brien Lighthouse, where our members have achieved a remarkable win with a significant pay increase and enhancements around ratios. As The Lamp goes to print, at St Vincent’s Australia there is an in-principle agreement for ratios and an 11 per cent pay rise over three years.
The employer shifted significantly after five rounds of industrial action. But they also faced a labour market for nurses that had changed suddenly and considerably. This is something we will return to in the next edition of The Lamp
All private health sector employers need committed, motivated, highly skilled nurses. They are pivotal not only to deliver high-quality care for patients, but also to the commercial brand of these companies.
I will say it again: nurses have choices.
Which brings us to the public health system. As The Lamp goes to print, our public health system branches are voting on the 2023 pay and conditions offer.
Negotiations have been tough and we have achieved some benefits on top of the ratios commitments that should be enshrined in a Memorandum of Understanding which we are currently working on with the government.
The MOU will be enforceable and, as in aged care, our job will be to hold the government to account. It is a significant milestone on our journey to building a sustainable public health system.
The government’s final pay offer of four per cent won’t be enough to attract or retain nurses and midwives, especially as competition for these staff will accelerate in other sectors.
Our short-term response was determined by your vote.
But the medium- and long-term goals will be to convince the government and its treasury of the imperative to invest in the public health system and its workforce.
The government’s pay offer is for one year. We will not stop until we achieve our objectives.
If employers in any sector want to be able to attract and retain nurses, they are going to have to raise their game in terms of remuneration, conditions of work and standards of care.
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To enter the competition, simply email your name and membership number with the subject: Canberra to lamp@nswnma.asn.au
NSWNMA branches of St Vincent’s Private and Mater Hospitals have been in negotiations with management to secure fair pay and working conditions within the Enterprise Agreement (EA) framework for the past eight months. The EA bargaining with management came to a halt, resulting in mass protected industrial action at both hospitals since December last year.
However, on 5 July, St Vincent’s Health Australia finally agreed to implement nurse-to-patient ratios on all shifts, in all clinical areas, from July 2024.This is a real investment in the nursing workforce across both sites.
We credit the efforts of every member who participated in this extraordinary campaign.
Member leaders presented to our executives pledges of support from over 1140 staff across both sites. Thereafter, members voted to participate in our first strike on 22 December. Most of our nursing colleagues attended. Impressively, many non-nursing colleagues also joined us. Many came on their days off, with their children and grandchildren.
It really was a momentous day. The first rally endorsed just what solidarity and unity looks and feels like.
The SVPH branch voted to participate in an Association scrub-wearing day, five consecutive lunchtime rallies and multiple stop work rallies. Nine in total.
We met with political allies and were overwhelmed by their support.
It took enormous courage for our members to stand up and seek change. To take actions that have not been taken by nurses in the private health system for decades. Now, the branches of SVPH and the Mater take enormous pride in all that our members have achieved by standing together.
Kate Westwood, RNIf there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card. The letter judged best each month will receive a $50 Coles Group and Myer gift card.
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I have been a registered nurse for more than 30 years.
Working on the wards has become a ‘tick the box’ exercise, with management putting greater emphasis on assessments and ticking of boxes, rather than on nurses taking the time to ensure patients receive the right level of care.
It saddens me to think that nursing has become an assessment, computer-driven and productivityorientated profession. This is all while patients lie in a bed, often with missed care. To be told “he had a wash and bed change yesterday, so he will be okay today” is simply not good enough in my book.
I have also experienced scenarios where a patient has missed a meal due to nursing staff being too busy to feed them. Maslow’s hierarchy of needs puts food and water as a basic need, but due to staff shortages, patients are not receiving this fundamental care.
I feel the time has come for nursing to get back to basics. In doing this, we would be checking patients for pressure injuries, asking about their pain, monitoring their bowels, and listening to their chests. This all prevents issues that arise from patients being left in bed with a lack of care interventions.
While we wait for ratios to be implemented and staffing numbers to improve, we must try to remember to curb our over-reliance on technology and get back to the basics of nursing care: talking to our patients.
Siobhan Mills, CNSIn 2021, 36.7 per cent of pregnant women in New South Wales had a caesarean birth. Yet most were denied the chance to have a maternal-assisted caesarean section, as they are not common practice in our hospital system. But they should be.
A maternal-assisted caesarean birth is a mode of delivery that allows the mother to be actively involved in her birth. This method allows the mother to reach down to help pull her baby out of her womb and lift her baby straight onto her chest for immediate skin-to-skin contact. Empowering women to be more involved in their caesarean births will lead to a warmer and more positive experience for mothers in an environment that can be seen as clinical, cold and unnerving. Maternal-assisted caesarean sections also demonstrate improvements in maternal and neonatal wellbeing, including early commencement of breastfeeding and delayed cord clamping. When we give our women birthing options and when we support their informed decisions, we see new mothers entering the postpartum period with a sense of pride and contentment, and that paves the way for positive mental health in motherhood. Maternal-assisted caesareans provide women with options and ultimately, it is what women want, and deserve, when they prepare to birth their babies.
Jessica Plater, midwife
In response to the health and wellbeing article in the last Lamp edition, I was impressed by the quality of the description regarding compassion fatigue. Having worked as an RN for 30 years in nursing homes, I became well aware of the term ‘compassion’ and the need for it in the workplace. However, I had not paid much attention to the concept of compassion fatigue.
But having read the description in the last edition, I now have the words to describe what I have experienced. I now know how easily compassion fatigue can sneak up on you. The signs and symptoms of compassion fatigue had become a daily experience that consumed me, but I never had the language to describe the feelings. Compassion fatigue had not only impacted my working life, but it had also become more of a problem in my off-duty life.
In 1994, I became a carer for my daughter as she struggled with the diagnosis of a mental health crisis. For her, this became Borderline Personality Disorder, Obsessive Compulsive Disorder, Schizophrenia and Bipolar Disorder. As my nursing shift ended, my caring shift began as I started looking after my daughter. The extra role I gained as her carer was not one I could leave; there was no end to this shift.
Sadly, my story is not uncommon.
Judy Nicholas, retired nurse
The aged care sector has taken two historic steps towards better staffing and decent wages for nurses and other employees.
Federal legislation to make residential aged care facilities roster registered nurses on duty 24/7 came into effect on 1 July.
Some facilities had been operating without a single RN on site, despite a general rise in the clinical needs of residents.
Also on or after 30 June, a 15 per cent increase in award wages started to flow through to nurses and carers in the residential and home care sectors.
Approved by the Fair Work Commission and funded by the federal Labor government, it is the biggest wage increase ever achieved in aged care.
And there are more improvements to come, including mandatory minimum care minutes starting in October this year.
These significant reforms are the fruit of years of hard campaigning by members of the NSWNMA and other aged care unions.
“Tirelessly, our members collected signatures on petitions, held street stalls and public forums, contributed to state parliamentary inquiries, met with politicians and stakeholders, and gave evidence at the historic aged care royal commission,” NSWNMA General Secretary, Shaye Candish, said.
“The 15 per cent award increase goes a long way towards recognising the
value of a historically underpaid workforce and will help the industry to attract and keep staff – thereby delivering much-improved care for elderly residents.
“In addition, some assistants in nursing will also be entitled to a 5.75 per cent increase to minimum award rates. This will be a significant boost for some of our lowest-paid workers in the aged care sector.
“It is great to finally see a federal government brave enough to promise reform of the aged care sector and subsequently deliver it.”
Shaye said nursing unions are working with the government to make sure employers are accountable for implementing the 15 per cent award wage increase in full, as the government intends.
The government is giving $11.3 billion to providers to cover the 15 per cent increase for RNs, ENs, AiNs, personal care workers and lifestyle workers.
Guidelines published by the Federal Department of Health and Aged Care show what the 15 per cent increase is worth in dollar terms for all classifications (see tables at www.health.gov.au/sites/default/ files/2023-06/aged-care-workerwages-guidance-document.pdf ).
“It is vitally important that [aged care workers] receive the full benefit of this funding so the aged care sector can attract and retain a skilled workforce,” says the department’s guidance document.
By law, members who are paid award rates should have received the new higher award rates from the first full pay period on or after 30 June.
The government also expects providers to pass the increase on to workers who are paid aboveminimum award rates, in line with the published tables.
‘It is great to finally see a federal government brave enough to promise reform of the aged care sector and subsequently deliver it.’
— NSWNMA General Secretary, Shaye Candish
The tables show that if you earn above-award wages (usually via an enterprise agreement) you should get the same increase in dollar terms as workers on the award.
Workers should not expect to receive a full 15 per cent on top of enterprise agreement rates, the guidance document warns.
It also says, “Providers must pass on all additional funding allocated to wage increases to their workers in the form of an increase in wages.”
“Funding should not be used for short-term localised incentives, which apply to only some staff in a
particular area/s of labour shortage. “Any short-term incentives should be funded from the provider’s own resources.”
The 15 per cent increase is fully funded with taxpayer dollars and the department’s guidelines make it clear this increase should not be used as an excuse to restrict enterprise bargaining.
The guidance document says, “Providers can pay over and above the amounts set out in this guidance and the government expects the usual enterprise bargaining to occur, with periodic wage increases drawn from the provider’s funding as in past years.”
The document states providers will need to tell individual workers their old and new wage rates via letter or email.
“The government also urges providers, as far as possible, to undertake workforce communications in consultation with unions and other employee representatives,” it says.
“Where appropriate this should involve joint communications, including paid workplace meetings.”
For-profit and not-for-profit providers of residential care and home care packages will need to state in their quarterly financial report that all funding provided to implement the 15 per cent wage increase is passed on to workers.
“Providers are required by law to provide accurate information to the government,” the guidance document warns.
“The department will work with the employer peaks and unions to follow up worker complaints.”
From the fourth quarter of the current financial year (April to June 2024), the quarterly financial report will also collect additional information about wages, including the minimum and maximum wage rates for direct care workers, as well as information on the primary way workers are being paid (i.e., award, enterprise agreement, individual agreement).
“The department will closely monitor providers’ expenditure on labour costs and identify trends in this spending over time,” the document says. n
The difference in dollar terms between the old Nurses Award rate and the new award rate:
‘Providers must pass on all additional funding allocated to wage increases to their workers in the form of an increase in wages.’ — Federal Department of Health and Aged Care
and having a pay packet that will be able to cover the cost of living, with money left over to save and invest for the future.”
A wage that reflects the social value of aged care work “will make it possible for aged care nurses to be able to get ahead and plan financially.”
Requiring nursing homes to roster RNs on all shifts from 1 July will contribute to safer and higher quality care for all residents, says Western Sydney RN Angelin Maharaj.
Her own facility has always had RNs on duty 24/7, but other homes run by the same provider have been using ENs on night duty.
“We are so happy, because having RNs 24/7 means there will be reduced risk of harm to residents across all our facilities,” said Angelin, who is a delegate for her NSWNMA workplace branch.
“Qualified and experienced RNs will be available on all shifts, to identify potential risks and give residents better access to care, and it will allow us to manage issues as first responders.
“This will improve resident safety and prevent unnecessary trips to ED.
“An RN on site 24/7 will also mean we will keep and recruit new RNs who join the aged care workforce.
As an NSWNMA member in aged care, Angelin has been a part of union efforts to publicise the needs of the sector and lobby for reform.
She has attended rallies, collected signatures on petitions and joined
fellow members in delegations to meet members of parliament.
As she told The Lamp in 2021, “We are all going to be old one day. We all need to raise our voices to protect vulnerable residents.”
In that article she described how her workplace had suffered a steady decline in staff hours.
“Staff are burning out from overwork. If they call in and can’t be replaced, it then puts more pressure on everyone else. We have been seeing it even more during the pandemic,” she said.
Speaking to The Lamp recently, Angelin said staff were “overjoyed” to be getting a significant pay increase from 1 July.
“Nurses in aged care have been working harder and longer with little to no recognition. We are the workforce who has always been undervalued and underpaid, and it has gone on for far too long.
“Now, staff are satisfied that finally we are being heard, and that the crucial work we do is being recognised and valued.”
Angelin sees the pay rise as the start of a process towards “a decent wage, getting paid what we deserve,
At first, her employer wrongly advised that the 1 July pay increase would not apply to RNs on the grounds they were already paid more than AiNs. “Our union officials assured us it doesn’t matter what anyone (from management) says, we will get the pay increases we are entitled to. We were very happy to hear that.
“With the union by our side supporting us all the way, we secured the 15 per cent award increase for all AiNs and RNs in all facilities.”
Angelin said the 1 July union gains had prompted “a significant number” of staff members to join the NSWNMA.
“Some are new members while others are rejoining after a period of absence. Many of them say the pay rise means they can more easily afford to pay union fees.” n
‘With the union by our side supporting us all the way, we secured the 15 per cent award increase for all AiNs and RNs in all facilities.’
— Angelin Maharaj, registered nurse
‘We are so happy, because having RNs 24/7 means there will be reduced risk of harm to residents across all our facilities.’
Members say the true value of aged care work is finally being recognised.
The long-awaited aged care pay increase has motivated more staff to join the NSWNMA at the Albury nursing home where AiN Lannelle Bailey is employed.
Lannelle, who is secretary of her NSWNMA workplace branch, spoke to The Lamp in July, when staff were about to receive the equivalent of a 15 per cent pay increase.
“Everyone is looking forward to the pay rise, but they’re a bit on edge not knowing if they will be paid the correct amount,” she said.
“However, they know the union will take up their case if necessary.
“Workers know it will be a lot easier to get their correct entitlements if they band together with other union members.
“Our workplace has a lot of anomalies regarding rates and classifications and it’s very hard to address these issues if you are just one person taking up your case with management.”
Lannelle said it is important to strengthen workers’ bargaining power by building branch membership.
“As a branch, we keep as many people in the loop as possible, whether they are members or not.
“We’ve been getting a lot of questions about the pay rise. It’s a good opportunity to show people the value of union membership.”
She says the branch has also been strengthened by recent visits from NSWNMA organisers.
Lannelle regards recent union gains, such as the 15 per cent pay increase and mandatory RNs on all shifts 24/7, as “just the start” of a process towards adequate recognition of the value of aged care work.
“Our work is very intense; an AiN can be responsible for up to 15 people, and we have to get them up every morning, take them to the toilet and shower them.
“We don’t have enough time to meet the needs of all residents and they sometimes get upset, so you have to manage that.
“It is a heavy workload and a big responsibility.”
Lannelle’s workplace is covered by an enterprise agreement (EA) that expired one year ago.
A successful union campaign for the next EA will be vital if workers are to cope with inflation and rising interest rates, she said.
“Our EA pay rates have not increased since 2021 and staff are asking branch officials when the rates will increase and when they will receive back pay, because it is so tough to survive on our current wage rates.”
Lannelle welcomes the introduction of mandatory minimum care minutes for aged care due to start in October this year.
This includes 40 minutes of mandatory RN care per resident per day.
“The RN quotient at our workplace will double – assuming they can be recruited.
“More RNs would relieve pressure on care staff who usually don’t get enough training to recognise and respond to residents’ clinical issues.
“Without adequate training, inexperienced care staff often lack the confidence and skills to detect changes in residents’ behaviour that might warrant further investigation – and then to raise the matter with a senior AiN or nurse.
“Lack of staff education is a big issue we need to tackle.
“As big corporations take over multiple facilities, the role of an on-site educator is often replaced by someone working out of head office and moving around various workplaces.
“That limits staff access to the educator and how much the educator can actually achieve.”
‘Workers know it will be a lot easier to get their correct entitlements if they band together with other union members.’ — Lannelle Bailey, assistant in nursing
‘We've been getting a lot of questions about the pay rise. It’s a good opportunity to show people the value of union membership.’
In July, nurses and care workers at Scalabrini aged care facilities received welcome news in a letter from its chief executive officer, Richard de Haast.
He advised that eligible employees would receive a substantial increase to aged care award rates of pay, as ordered by the Fair Work Commission and funded by the federal government.
His key message was: “We have committed to pass through every dollar in funding that we get, to you and your colleagues.
“This increase is made on the award rate for the industry and we already pay you above that rate. We will pass through the dollar amount to you, which means that you will continue to be paid above the award rate.”
The CEO advised that Scalabrini, which operates six nursing homes
in NSW, would also pay a separate national wage increase awarded by the commission to workers in all industries.
All eligible employees received individually addressed letters setting out their pay increases in dollar terms.
For example, an AiN team leader was advised she would get an extra $5.53 per hour, bringing her hourly rate to $39.60.
“We believe that this amount better reflects your contribution to the lives of our residents. We are pleased and grateful that the government is funding a large portion of this increase,” Richard de Haast wrote.
“I would like to thank you very much for your ongoing commitment to delivering outstanding support and care to our residents. Each time you come to work, you have the
Aged Care Watch:
Aged Care Watch allows aged care workers, residents, and family members to report and visually understand the thousands of understaffing and workload issues in aged care facilities across Australia.
https://agedcarewatch.org.au/
The Australian Department of Health and Aged Care has conducted some useful webinars on the new changes in aged care:
• One webinar provides information about the Australian Government’s $11.3 billion investment to fund the Fair Work Commission’s decision of a 15 per cent increase to the award wages of many aged care workers.
• A second webinar provides information to the residential aged care sector on the new registered nurse (RN) 24/7 responsibility.
https://www.health.gov.au/topics/aged-care/aged-careresources/webinars-for-the-aged-care-sector n
opportunity to make a positive impact in the lives of our residents; thank you for doing this.”
Scalabrini RN Neeta Kunwar
Neupane said staff initially were worried they might not get the full increase.
However, the NSWNMA visited her facility and spoke to workers before they got the CEO’s letter.
“Our union officials told us our rights and Scalabrini has listened to those messages,” Neeta said. “We were happy to get the company’s letter promising the pay increase and giving good feedback on our work.
“We were even happier when we got the increase in our first pay period after 1 July.” n
Nurses and direct care workers in both residential and home care became entitled to a 15 per cent award pay correction from 1 July for their work value.
The federal government has issued clear instructions to employers –by law they must comply with the new minimum award rates. These resources will help you determine what resources you should be getting from 1 July: Guidance on aged care worker wages:
The Australian Department of Health and Aged Care has produced a guideline that clearly lays out the responsibilities of
employers to pass on the full government funding of $11.3 billion to their employees.
https://www.health.gov.au/sites/ default/files/2023-06/aged-careworker-wages-guidance-document. pdf
The NSWNMA has produced an Aged Care Wage Checker form, so you don’t have to wait for your employer to get in touch; you can contact the Association to find out exactly what you should be receiving.
https://www.nswnma.asn.au/ aged-care-pay-rise/
Myth
Aged care facilities won’t be required to adhere to RN 24/7.
Fact
The federal government is confident most aged care providers will have or are almost able to provide RN 24/7 from 1 July. Some facilities have been granted exemptions from this requirement until 1 July 2024. A strict criterion has been applied to these approved providers.
Myth
Aged care facilities won’t be able to afford to hire RNs.
Fact
The federal government has provided extra money for aged care providers to fund additional nurses to meet the RN 24/7 deadline. They have invited providers who think they cannot fund this requirement to work with them directly.
Myth
Aged care providers will only be required to have one RN on duty at all times.
Fact
The RN 24/7 requirement will be implemented along with the federal government’s direct care minutes policy. This means that the required number of staff will be based on resident numbers and acuity.
As a result, most aged care facilities should see an increase in staffing levels, including both RNs and care staff.
Myth
There aren’t enough RNs to satisfy the RN 24/7 requirement.
Fact
The federal government has introduced a number of measures to address the nursing shortage in aged care. This includes:
• funding the aged care work
value case, resulting in a 15 per cent increase to the aged care rate
• providing funding for the aged care bonus payment for aged care RNs
• expanding the Aged Care Nursing Scholarship Program.
Myth
RN 24/7 means there is no place for ENs in aged care.
The federal government has identified ENs as part of the aged care workforce in their care minutes and RN 24/7 guidelines. From October 2023, EN care minutes will be published with Star Ratings.
The ANMF is currently lobbying the federal government to have EN minutes separately included in the care minutes policy in recognition of their valuable contribution to the delivery of clinical care. n
As The Lamp goes to print, the NSW Ministry of Health and the state government have put forward their final offer in response to our log of claims.
After months of talks, the NSW Ministry of Health and the state government have offered a 4 per cent pay rise and a 0.5 per cent superannuation increase, back paid to 1 July 2023, in a one-year agreement.
The offer is consistent with a 4 per cent pay rise for all public sector workers which other public sector unions had already accepted.
The government says it will commit to ratios in key areas. This will lead to a variation in the Award in October this year, which will contain a schedule of sites for conversion to ratios.
Safe staffing ratios will be implemented in five key areas including:
• the conversion of NHPPD wards and units to shift-byshift ratios
• 1:3 in emergency departments
• 1:3 in postnatal maternity and a review of Birthrate Plus
• ICU staffed to the latest Australian College of Critical Care Nurses (ACCCN) Professional Standards, and
• three nurses on each shift in MPSs, where the ED is open 24/7.
NSWNMA General Secretary, Shaye Candish, said the offer includes other improvements to conditions won by members.
“These include the right to leave early or be paid overtime on night shift if your paid breaks are not provided. When working overtime, you’ll be able to choose between being paid a meal allowance or the provision of a meal.
“Nurse managers who are Grade 4 or above will now be eligible to receive an on-call allowance. There are also improvements to the current Grading Committee process. That means there will be collaboration on the grading of positions beyond NUMs.
“The current 20 days’ paid family and domestic violence leave will be included in your Award, to protect your
“It remains to be seen if this is enough to attract and retain nurses and midwives in our public health system”
— NSWNMA General Secretary, Shaye Candish
entitlement,” she said.
There are also ‘partial’ improvements:
• A clause that recognises the impact of wearing full PPE. This means no-one will be required to work for more than two hours in full PPE without a break or change in tasks.
• New graduate nurses and midwives will be entitled to a minimum of five supernumerary shifts per annum.
As The Lamp goes to print, NSWNMA branches are voting on whether to accept the offer.
NSWNMA Assistant Secretary, Michael Whaites, said if the majority of branches vote to accept the offer, the Award will be made by consent in the Industrial Relations Commission shortly after the vote closes.
“The 4 per cent increase plus the 0.5 per cent super will be paid likely within a few weeks with back pay to 1 July included,” he said.
“Given the Ministry has already submitted the Award to the Industrial Relations Commission, there’s every possibility the Commission would push through the new Award anyway, including the 4 per cent pay increase and other changes. This has been done in the past.
“It’s important to note that until the previous government’s wages policy is repealed, the Commission can’t make awards with higher pay increases unless the government agrees, and the government won’t agree unless they feel significant pressure to do so.”
Shaye Candish said there are undeniable gains in the proposed agreement but “it remains to be seen if this is enough to attract and retain nurses and midwives in our public health system”.
“The trends are in the right direction but the government needs to understand that improvements in pay and conditions in aged care, which are now also beginning to flow into private hospitals, will give nurses choices about where they want to work.
“The government needs to move away from the mentality that health is an expense that burdens the bottom line, and see it as an investment in the wellbeing of New South Wales.” n
A 4 per cent pay increase plus 0.5 per cent superannuation, backdated to 1 July 2023. Ratios will be implemented in five key areas across a schedule of sites from October 2023:
• Conversion of current NHPPD units to ratios
• 1:3 in EDs
• 1:3 in postnatal and a review of Birthrate Plus
• ICU staffed to the latest ACCCN Professional Standard
• 3 nurses on shift in MPSs, where ED is open 24/7
• The right to leave early or be paid overtime on night duty where meal breaks are not provided
• Improvements to current overtime meal allowance provisions
• Extension of on-call allowance to Nurse Managers Grade 4 and above
• Improvements on current Grading Committee process
• Family and Domestic leave provisions. n
“It’s important to note that until the previous government’s wages policy is repealed, the Commission can’t make awards with higher pay increases unless the government agrees.”
— NSWNMA Assistant Secretary, Michael Whaites
The NSWNMA has embarked on a path towards representation and leadership for Aboriginal and Torres Strait Islander members within the Association.
Our annual conference will consider a NSWNMA Council proposal to support the formation of a statewide Aboriginal and Torres Strait Islander branch of the union.
The Council also proposed creating two dedicated Aboriginal and Torres Strait Islander positions on Council, one each for a nurse and a midwife. Both proposals will be put to a vote at the union’s annual conference in August.
The proposals came from the first meeting of Aboriginal and Torres Strait Islander members of the Association in February.
Aboriginal and Torres Strait Islander members at the meeting included Jo Burton, a primary healthcare nurse practitioner for Justice Health. She said the inaugural meeting of Indigenous members was initiated by General Secretary, Shaye Candish, and Assistant General Secretary, Michael Whaites, after they took over leadership of the union in mid-2022.
“The new leadership team wanted to find out what we wanted and how they could help us achieve it,” Jo said.
“Our group came up with some important ideas on developing the leadership skills of Aboriginal and Torres Strait Islander members.
“We agreed the best format would be to create a branch for Indigenous members with similar interests and needs to discuss issues separate from those a normal branch would deal with.”
She said Indigenous members “carry an extra load taking on responsibility for Aboriginal and Torres Strait Islander patients and the health and wellbeing of our community”.
“First Nations members have a unique experience of the systemic, entrenched racism in society that occurs on a daily basis.
“It’s not necessarily malicious, and a lot of non-Indigenous people would not even recognise or understand it.
“However, as an Indigenous workforce we need to address it.
“We need a forum to discuss and act on issues specific to the experiences of First Nations nurses and midwives.
“By having a platform within the union, we will be able to represent
Issues discussed at the inaugural meeting of Aboriginal and Torres Strait Islander NSWNMA members included:
• cultural safety
• creating opportunities for members to identify as Aboriginal or Torres Strait Islander
• empowering Aboriginal and Torres Strait Islander members
• advocating for better health outcomes for Aboriginal and Torres Strait Islander patients
• staffing issues
• industrial entitlements around culturally specific issues such as “sorry business” and the Yes for Voice campaign. n
First Nations members in a way that reflects their cultural needs.”
As an example, Jo cited the need for industrial awards to recognise ‘sorry business’ – Indigenous cultural practices and obligations associated with grief and mourning.
“Our award allows for family leave but not necessarily in the context that First Nations people define and experience family.
“It is cultural practice for many Aboriginal people to be raised by their grandmother or auntie – but if they die, nurses and midwives can’t normally get bereavement leave.”
Jo said the existence of a formal network for Indigenous members would make the union “more relatable and relevant” to Indigenous nurses and midwives.
“I think a lot of members joined the union before they had the option of identifying as Aboriginal or Torres Strait Islander on the membership form.
“A formal network specifically for Indigenous members will give people an opportunity to identify and embrace their culture in a more supported way.” n
‘By having a platform within the union, we will be able to represent Aboriginal and Torres Strait Islander members in a way that reflects their cultural needs.’
— Jo Burton, primary healthcare nurse practitioner for Justice Health
The authors of the Statement from the Heart called for members of the Voice to be chosen by First Nations peoples based on the wishes of local communities.
Writing in The Conversation, three law professors (Gabrielle Appleby, Geo ff rey Lindell and Hannah McGlade) answered the question this way:
In late 2023, Australians will have their say in a referendum about whether to change the Constitution to recognise the First Peoples of Australia by establishing an Aboriginal and Torres Strait Islander Voice.
The specific question on the ballot paper will be:
“A Proposed Law: to alter the Constitution to recognise the First Peoples of Australia by establishing an Aboriginal and Torres Strait Islander Voice. Do you approve this proposed alteration?”
The Voice would be an independent Committee advising parliament and the government on matters affecting Aboriginal and Torres Strait Islander Australians.
• The Uluru Statement from the Heart: https: //ulurustatement.org/ the-statement/view-the-statement/
• Rachel Perkins: The Uluru Statement from the Heart Background Video: https:// ulurustatement.org/education/ resources/
• “History is Calling” video https://www.youtube.com/ watch?v=5gF6DqYH6FE
• Nurses and Midwives for the Voice: Sign the pledge in support of the Voice and find more resources for the campaign. yes.ausunions.io n
The proposal stems from the Uluru Statement from the Heart in 2017. That statement was issued following a meeting of hundreds of Indigenous elders and community leaders at Uluru.
A constitutionally enshrined Voice was a key element of that statement.
“We seek constitutional reforms to empower our people and take a rightful place in our own country,” the statement said.
If the referendum succeeds, the Voice would be enshrined in the Constitution. The details of how it operates would be left to parliament to decide.
“Aboriginal and Torres Strait Islander people have answers to many pressing issues confronting their communities, but all too often are not heard.
“The Voice will give (them) a constitutionally guaranteed right to speak to government and the parliament about what’s needed for practical improvements to people’s lives. This in turn would help address disadvantage and systemic discrimination.”
The professors pointed out that if the Voice is in the Constitution, it can only be abolished by another referendum, rather than by a change of government policy.
“This gives it independence and stability, so it can fulfil its function of speaking about matters that might not be politically popular,” they said. n
If the Voice is approved at the referendum, the following words will be added to the Constitution:
Chapter IX Recognition of Aboriginal and Torres Strait Islander Peoples
In recognition of Aboriginal and Torres Strait Islander peoples as the First Peoples of Australia:
1. there shall be a body, to be called the Aboriginal and Torres Strait Islander Voice
2. the Aboriginal and Torres Strait Islander Voice may make representations to the Parliament and the Executive Government of the Commonwealth on matters relating to Aboriginal and Torres Strait Islander peoples;
3. the Parliament shall, subject to this Constitution, have power to make laws with respect to matters relating to the Aboriginal and Torres Strait Islander Voice, including its composition, functions, powers and procedures. n
When we listen to people before making decisions that affect them, we get better results. That’s what the Voice is about.
Birthing on Country programs aim to engage Aboriginal and Torres Strait Islander women in effective antenatal care.
Infant mortality rates among Indigenous Australians are almost double those of other Australian children.
Indigenous babies also have higher rates of low birth weight, with maternal smoking a major contributing factor.
The Birthing on Country (BoC) movement has arisen over recent years with the aim of reducing these and other health disparities. BoC services aim to be community-based and governed, and are developed by, or with, Indigenous Australians. They aim to incorporate traditional practice, value Indigenous and nonIndigenous knowledge and practice, be culturally competent and adopt a holistic definition of health.
Southern Cross University (SCU) has secured a $3.6 million federal government grant to design a BoC program in collaboration with three Aboriginal community-controlled health organisations.
Dr Marilyn Clarke, who graduated as Australia’s first Aboriginal obstetrician and gynaecologist in 1997, is jointly leading the SCU project.
She grew up in Port Stephens near Newcastle and credits her mother, Grace Kinsella, a Worimi woman and passionate community nurse, for inspiring her to become a doctor.
“Also, the hospital system is very focused on acute management. Hospital settings are not designed to connect with Aboriginal people in their communities and there’s often no continuity of midwifery care.
“Having a known and trusted carer is important to all women and Indigenous women in particular, because it provides a sense of safety.”
Dr Clarke said there is still a disparity in rates of perinatal mortality, maternal mortality, and medical conditions such as preeclampsia and gestational diabetes.
BoC programs aim to reduce these inequities by engaging Aboriginal
Dr Clarke said the essence of BoC is “providing culturally safe care where the woman is feeling safe and empowered in her pregnancy journey. It is also about providing holistic care that incorporates social supports and meets the woman’s cultural needs as well.
“Historical and inter-generational trauma has often led Aboriginal women to have a negative view of hospitals,” she said.
‘Historical and inter-generational trauma has led Aboriginal women often to have a negative view of hospitals.’
Aboriginal obstetrician and gynaecologist Dr Marilyn Clarke is a supporter of the proposed Aboriginal and Torres Strait Islander Voice to parliament and government.
“As an Aboriginal person who has worked in Aboriginal health for my entire career and been a consumer of Aboriginal health services for myself and my family, I’m a witness to the importance of having an Aboriginal voice at the table when things are being designed and implemented,” she said.
“If the referendum is successful, the Voice will give us an input at the national level into programs and policies that are going to directly affect us.
“Without such an input, programs and services for Indigenous people will not be as effective. That’s been proven in Australia time and time again.” n
and Torres Strait Islander women in effective antenatal care, and ensuring mums and their pregnancies are as healthy as possible.
Dr Clarke added that a Birthing in Our Community service implemented at Mater Mothers Public Hospital in Brisbane achieved a significant reduction in preterm births.
The service also cost less than standard care due to fewer interventions and procedures in birth and fewer neonatal admissions.
Maternal smoking has a strong association with low birth weights and the SCU BoC project will tailor a quit-smoking program to the needs of partner communities.
Dr Clarke said smoking rates among Indigenous women are slowly coming down, but at 44 per cent it is still almost quadruple the nonIndigenous rate of 12 per cent.
SCU has a midwifery program at its Coffs Harbour and Gold Coast campuses, with the provision of culturally appropriate care part of the curriculum.
The SCU BoC project aims to boost the number of graduating Aboriginal midwives through an increase in scholarships and opportunities.
“Having an Aboriginal midwife can make a massive difference to Indigenous mothers, yet they are a tiny part of the overall midwifery workforce,” Dr Clarke said.
“The federal government grant includes scholarships for Aboriginal people to do the midwifery course and have placements out in the communities we are going to partner with.”
She believes the involvement of Aboriginal communities in the design of maternity programs is vital to their success.
“In designing our project, we will go out to our partner communities and involve them from the ground up.
“We want them to be co-designers of how BoC would look for their communities, how smoking cessation training can be adapted to their needs, and how Aboriginal midwives can be incorporated into the model of care.” n
‘Having an Aboriginal midwife can make a massive difference to Indigenous mothers, yet they are a tiny part of the overall midwifery workforce.’
— Dr Marilyn Clarke
After more than a decade of lobbying by nursing unions, Australia now has a government committed to allowing nurse practitioners (NPs) to work to the full extent of their education and ability.
The federal Labor government’s May budget allocated $50.2 million to fund 1850 postgraduate scholarships for RNs to become NPs.
The budget also allocated $46.8 million over four years from 2023–24 to fund:
• a 30 per cent increase in patient rebates for a consultation with an NP
• enabling NPs to participate in allied health multidisciplinary case conferences by giving them access to MBS case conferencing items
• enabling NPs to independently prescribe PBS medicines and provide services under Medicare without the need for a legislated ‘collaborative arrangement’ with a doctor.
Until now, NPs have been required to make agreements to form “collaborative” work arrangements with doctors or be employed by services that have doctors.
Without such arrangements, patients have been denied Medicare rebates on the cost of NP services, or PBS subsidies on prescriptions written by NPs.
Professor Mary Chiarella of Sydney Nursing School has described the collaborative arrangements requirement as a waste of doctors’ time and “an insult to the professionalism” of an NP working well within their scope of practice.
“Not every patient needs to see a doctor every time they visit a primary healthcare setting,” Prof. Chiarella, a former NSW Health chief nurse, wrote in 2022.
— Lesley Salem, NP
“Many patients can and are managed by a nurse for chronic disease management, lifestyle and selfcare support visits, immunisation, dressings, and care coordination. However, the system consistently undermines this.”
Despite the May budget measures, the government still has a lot of work to do to allow NPs to work to their full scope of practice – as its NP workforce plan acknowledges (see p. 22).
Experienced NP and NSWNMA member Lesley Salem is among five NPs working at a remote Queensland Aboriginal community, who were recently terminated by their employer, an Aboriginal health service.
They have been replaced by flyin fly-out doctors from a Sydneybased agency.
“Most of the doctors are from overseas, with little cultural
‘NPs are incredibly underpaid for doing the same procedures a doctor does.’LESLEY SALEM, NP
understanding of Aboriginal people and some have poor English,” Lesley said.
However, the health service must generate its own income and can make a lot more money using doctors who have unimpeded access to the MBS.
Lesley said it is the fourth health service she has worked at where NPs have been replaced by doctors for financial reasons.
“Under the MBS, NP charges are time-based rather than procedurebased – we don’t have the full range of MBS item numbers available to us,” she said.
“I could be doing a pap smear or suturing somebody and I have to use the same time-based item number.
“Medicare has no idea what I’m actually claiming for.
“NPs are incredibly underpaid for doing the same procedures a doctor does.
“A doctor might get $70 (item 30032) for doing fewer than seven sutures. The same procedure would usually take me under 20 minutes, so I would get $19.55 (item 82205).
“NPs working in remote situations do Aboriginal health assessments but can’t access the relevant MBS item number 715, which pays a benefit of $232.50 to the doctor.
“NPs play a vital role in many Aboriginal communities but still can’t access the MBS item numbers related to Close the Gap initiatives, such as obtaining equipment and accommodation for patients.”
She points out another glaring anomaly: NPs are not allowed to give COVID-19 vaccinations and advice.
“Registered nurses can do it, pharmacists can do it, but the doctors’ lobby didn’t want us NPs doing it because they would have had to give us a Medicare number, which also serves as insurance for the doctor so they don’t have to take out separate indemnity insurance.
“Medicare is an incredible scheme and the doctors think it is their monopoly. It was set up for the people of this country, not as a tool for doctors to create wealth.” n
A nurse practitioner (NP) is an experienced registered nurse (RN) who has completed an additional master’s degree and been endorsed as an NP by the Nursing and Midwifery Board of Australia (NMBA).
The NP workforce plan recognises that NPs “have the skill, knowledge, expertise and legal authority to provide preventative care, and diagnose and treat people of all ages with acute and chronic health conditions.”
In releasing the plan in May, Assistant Federal Minister for Health and Aged Care, Ged Kearney, said NPs have existed for more than 20 years but the workforce remains small.
In 2021, Only 1549 NPs were working across Australia, while another 650 had completed their masters-level training but were still working as RNs, Ms Kearney said.
About 30 per cent of employed NPs work in regional, rural and remote areas.
“The NP workforce needs to grow, to help address inequities in access and outcomes so all Australians can get the care they need when they need it,” she added.
To be eligible for admission to an NP study program, an RN must have:
• current general registration as an RN with the NMBA
• a minimum two years’ full-time equivalent (FTE) as an RN in a specified clinical field and two years’ FTE of current advanced nursing practice in the same clinical field
• a postgraduate qualification at Australian Qualifications Framework Level 8 in a clinical field. n
‘The nurse practitioner workforce needs to grow to help address inequities in access and outcomes so all Australians can get the care they need when they need it.’
— Ged Kearney, Assistant Federal Minister for Health and Aged Care
GEDKEARNEY,
ASSISTANT FEDERAL MINISTER FOR HEALTH AND AGED CARE
Rules that prevent nurse practitioners (NPs) from working to their full scope of practice will be scrapped within one to three years under a federal government plan supported by nursing unions.
The Nurse Practitioner Workforce Plan outlines reform targets to be achieved in the short, medium and long terms.
Short-term goals (1–3 years) include giving NPs access to some of the Medicare Benefits Schedule (MBS) items that currently apply only to doctors.
LornaIn the same period, rules that restrict NPs prescribing medicines on the Pharmaceutical Benefits Scheme (PBS) will also be reviewed. In addition, laws will be reviewed to “set up a nationally consistent model to allow NPs to work to their full scope of practice”, matching their education and competency, the plan states.
These reforms will be accompanied by a “national NP awareness strategy” to promote the NP role. The plan is supported by the Australian Nursing and Midwifery Federation (ANMF), the national umbrella body for state-based nursing unions, including the NSWNMA.
ANMF Federal Secretary, Annie Butler, was a member of the plan’s steering committee.
She said the plan is needed to “recruit and retain NPs, and allow them to play a crucial role in the development of multidisciplinary models of care, which we believe is the future of Australia’s health and aged care systems”.
“The plan recognises the true value of NPs and how they can provide tangible solutions to the many challenges across the health and aged care sectors, which are impacting the delivery of timely, safe health care, particularly in rural and remote communities where there is limited access to a GP, or no GP at all,” Annie said.
“Expanding NPs’ scope of practice and introducing incentives, such as an increase in MBS rebates for their services, could finally allow NPs to provide people with direct access to safe, quality ‘everyday care’, without having to go through a GP.
‘It’s brilliant to finally see a government committed to change and progress for nurses.’
—
Scott, NP
“This will remove unnecessary duplication, cost and time-wasting for many Australians in underserved communities and ensure they can access quality care when and where they need it.”
The NP workforce plan builds on initial steps to support NPs announced in the May federal budget (see story page 20).
NP Lorna Scott, a member of the NSWNMA’s state council, welcomes the federal government’s NP reforms.
“It’s brilliant to finally see a government committed to change and progress for nurses,” said Lorna, who works as an NP in women’s health.
“The ANMF and Australian College of Nurse Practitioners have been arguing for change and participating in review committees for more than 10 years.
“At the moment, there are not enough positions available for all qualified NPs, but this is slowly changing.
The federal government’s NP workforce plan acknowledges the restraints on NPs trying to do their jobs.
It cites the case of “Adam”, an NP at a metropolitan hospital who assesses and treats adult patients diagnosed with cancer.
His daily routine ranges from in-person and telephone consultations to reviewing inpatients and patients presenting to ED with complications of cancer or associated treatments.
Adam’s patients require regular CT, MRI, ultrasound, or PET scans, which are not funded by Medicare when ordered by an NP, despite them having the training and competency in interpreting such results.
Adam often must wait to get requests signed by a medical practitioner, which can delay care, as there are days when no oncologist is on site.
Similarly, when prescribing chemotherapy and anti-cancer medicines, Adam must wait to get prescriptions from an oncologist, as there are no PBS rebates for those medicines when prescribed by an NP, despite this being a crucial part of his role.
“These barriers cause significant delays and inconsistencies in care for his patients,” the workforce plan states. n
“I’ve seen new nurse practitioner/ transitional nurse practitioner positions recently created in my own LHD, Hunter New England, which is great.”
Lorna said the government’s commitment under the workforce plan to allow NPs to access MBS item numbers would give NPs a major boost.
“If this reform goes through, NPs in private practice would no longer be restricted to time-based payments under the MBS.
“A review of the rules that prevent NPs from writing some initial prescriptions is also very welcome. “The budget announcement of $50 million for postgraduate scholarships for RNs to become NPs is also very forward thinking.”
She said about 650 NPs were currently working as RNs.
“It’s a lot to put yourself through a master’s degree and get authorised as an NP, then not be able to work in that capacity.
“Hopefully these changes will improve outcomes for all NPs and also be the incentive for nurses working in advanced practice to see the great opportunities that can be had to work as an NP.”
Lorna said Western Australia (WA) was setting the pace of reform with a pilot program to promote NPs working to their full scope of practice under a new multidisciplinary care model.
The federal and WA governments have provided $11.7M to employ 20 NPs in WA primary care settings under the pilot scheme. n
‘The workforce plan will allow NPs to play a crucial role in the development of multidisciplinary models of care.’ — Annie Butler, ANMF Federal Secretary
Bill was intended to be operative by 1 July 2023, but has now been referred to a Senate committee for review after intense lobbying by international business interests.
The bill introduces ‘country-bycountry’ reporting, which is designed to combat tax avoidance by requiring large multinationals doing business in Australia to publicly disclose more information about their financial affairs, including their tax strategy. This would include public disclosures of tax and other financial information in other jurisdictions, potentially exposing practices of shifting profits into tax havens.
NSWNMA Assistant General Secretary, Michael Whaites, said it was “deeply disappointing” that the proposed laws were put on the backburner.
“Country-by-country reporting is extremely important towards holding major corporations to account and ensuring they pay their fair share of tax in Australia. Those tax dollars will go towards funding our aged care reform, public health systems and affordable housing,” he said.
“To have this draft bill watered down and referred to a Senate committee raises concerns about the perceived influence big businesses continue to have in Australia today.”
The Guardian reported that the government had come under intense pressure to scale back its legislation from international business lobby groups.
One group, it reported, was “particularly combative”.
SwissHoldings, representing 62 Swiss-based multinationals, including the food giant Nestlé and the pharmaceutical company Roche, questioned how Australia could force international companies to comply with its proposed tax laws.
Labor has said work on the multinational tax integrity package continues.
The bill has garnered support from other countries. The investment management division of Norway’s central bank supports Australia’s plans.
“We expect companies to publish country-by-country breakdowns of how and where their business model generates economic value, where that value is taxed and the amount of tax paid as a result,” it said in a submission made public by the Senate.
Michael Whaites said the recent allegations against the financial services giant PwC show “it is clear more transparency is needed, not less, and not the status quo”.
In 2015, PwC was helping the federal government to design tougher multinational tax laws.
The company’s tax chief at the time, who had signed confidentiality agreements with the Australian Government, gave intelligence on government plans to PwC employees both in Australia and overseas. The firm used that information to give more than a dozen US companies a heads-up about the changes –netting millions of dollars for the company and depriving Australia of tax revenue.
The NSWNMA, along with other governance groups such as Transparency International, continue to press for government action.
“We seek tax justice in Australia and call on the federal government to be bold on integrity and transparency of the multinational corporations that operate in Australia,” Michael Whaites said. n
NSWNMA has raised concerns about federal government hesitancy on draft legislation that would combat tax dodging by multinational companies.
‘Those tax dollars will go towards funding our aged care reform, public health systems and affordable housing.’
— NSWNMA Assistant General Secretary, Michael Whaites
build a nuclear submarine base on the east coast of Australia and Port Kembla near Wollongong is widely considered the preferred location. The South Coast Labour Council, which represents unions in the Wollongong area, opposes the submarine base as a threat to proposed job-creating offshore wind projects that would use Port Kembla harbour.
Secretary of the NSWNMA’s Wollongong Hospital branch, Jamie Roberts, lives near Port Kembla and has a military background.
Jamie was in army signals intelligence for more than seven years before taking up a nursing career.
She supports military spending to give Australia a strong defence capability but does not agree that Australia needs nuclear submarines. She would like to see open discussion of conventionally powered alternatives to replace the existing Collins class submarines – as also advocated by former Labor PM Paul Keating.
Conventional subs would be cheaper,make us less of a nuclear target and probably do a better job of defending Australia, Jamie believes.
The NSWNMA has joined growing public opposition to AUKUS, the “security pact” between the United States, United Kingdom and Australia.
Joining AUKUS comes with a minimum $368 billion price tag – the official cost to Australian taxpayers of acquiring more than a dozen nuclear submarines capable of operating in waters near China.
As part of the deal, US and UK nuclear submarines (likely carrying nuclear weapons) will routinely begin accessing Australian ports from 2027. AUKUS will put Australia on the front line of any US-led war against China, critics say.
The AUKUS deal was negotiated in secret and announced by former Prime Minister (PM) Morrison in 2021 with no parliamentary discussion. Anthony Albanese immediately declared Labor’s full support
and reaffirmed that support in March 2023.
In May, the NSWNMA’s Committee of Delegates supported a motion from Westmead Hospital branch calling on the Association to publicly oppose AUKUS and assist members to lobby federal Labor Government MPs on the issue.
A sample letter drafted for the use of NSWNMA members calls on MPs to urge the government to withdraw from AUKUS, end the commitment to acquire nuclear submarines and direct money saved to healthcare, education and protection of the environment.
The $368 billion (minimum) submarine cost would fund construction of about 550 big-city hospitals (on the scale of Sydney’s Northern Beaches hospital, which cost $660 million) or employ 65,000 nurses for about 30 years.
The federal government says it will
“$368 billion is just the starting price for the nuclear subs – that amount is guaranteed to increase,” she says.
“Meanwhile, our state hospital system is crumbling and the federal health system is not being adequately funded.
Jamie says the Illawarra region’s hospital system is not equipped to handle a major accident at a nuclear submarine base.
“There are always incidents on any military base and any nuclearrelated accident would be extremely serious. We just don’t have the local hospital infrastructure to cope with that.” n
The NSW Nurses and Midwives’ Association is seeking members to join the Child and Family Health Reference Group. The group meet a minimum of four times a year to discuss current issues and challenges in the sector. Meetings are held via Zoom to allow members to be involved regardless of geographical location.
Current NSWNMA members working in child and family health are invited to join.
Being a member of the Child & Family Health Reference Group gives you the opportunity to:
be a voice for the issues impacting those working in the sector
provide feedback to the Association
assist in the development and reviewing of related policies
be a link between members and the Association
Our collective strength is in our numbers – the larger the membership, the louder our voice. You can help build the NSWNMA by recruiting a member.
$20
E-GIFTE-GIFT CARD
Once you have recruited 4 new members you will be entitled to an $80 e-gift card. For every new member you sign up after that, you will receive a $20 e-gift card.
Digital gift cards are emailed to recruiters at the end of financial year and valid for 3 years. Gift cards are not deemed to be income for the purposes of taxation.
*Conditions apply. To participate in this recruitment incentive scheme, you must be a financial member of the NSWNMA (Associate Members are not eligible to enter). Every new member’s application form must be accompanied by some form of payment – cheque, money order, direct debit, credit card authorisation form. Recruiter’s name and membership number must be written in the space provided on each new member’s application form. New recruits must remain as financial members for at least 3 months before being recognised by the scheme.
Have you recently moved house or changed jobs?
Changed your classification or email?
Are you a dual-registered nurse/midwife?
Let us know now!
Log on to online.nswnma.asn.au
Update your details
Go into the draw to WIN A TWO-NIGHT WEEKEND STAY AT WILDES BOUTIQUE HOTEL, KANGAROO VALLEY for two adults including:
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Everyone who uses our online portal from 1 April 2023 – 30 March 2024 to update their details will automatically be entered in the draw to win.
*The winner must be a financial member of the NSWNMA. Prize valid until 30 December 2024 and excludes stays over long weekend and school holiday peak periods. Booking and stay conditions may apply.
Keeping your membership details up to date is very important. If you’re a dual-qualified nurse/ midwife, you can now update your role in the NSWNMA member portal.
don’t realise what is going on until we talk to each other across the state.
New South Wales covers more than 800,000 square kilometers. This makes it one and a half times the size of France and it is bigger than one of Asia’s larger countries, Turkey.
Naturally this creates logistical issues for an organisation such as the NSWNMA with health services reaching to all corners of the state. It has never prevented NSW nurses and midwives from working together in common cause but now technology gives us opportunities to deepen those relationships, share experiences and resolve problems in new ways despite the issues of distance or isolation.
In this Branch Beat The Lamp looks at how our members at Australian Red Cross Lifeblood, in multiple workplaces and with staff dispersed across NSW, have married technology and traditional forms of organising to create an effective statewide network and branch.
Staff at Lifeblood collect blood, plasma and platelet donations, send them off to be processed and then released in hospitals and other health settings across NSW, and in some instances, they are also sent overseas.
They have 24 different donor centres across NSW. Kayla Wipiti, the branch secretary at Lifeblood NSW says this “is definitely a challenge”, different to other Association branches that can have face-to-face meetings.
Meeting on Zoom has played a large part in rising to this challenge and using the technology has its own advantages, she says.
“People don’t need to be at work the day of a meeting to attend: they can dial in while they are making dinner or when the kids have gone to bed.
“As bargaining goes on, we are getting more members joining our union and joining our Zoom meetings. And because we have members who have worked at lots of different sites and divisions of Lifeblood, we are able to look at issues in a lot more detail: you really
“I’m still learning if I am honest: every single day I am finding out new things that I did not know not only about the union but what is happening across the state.”
Kayla says the Lifeblood Enterprise Agreement expired in June 2021 and “since then, our pay has gone down in real terms, and we’ve had no improvements to benefits and conditions”.
This, she says, was the spur to form a branch in March of this year.
Starting from a low base, “union membership at Lifeblood is growing every week”.
The online conversations have also revealed a raft of other issues including around staffing.
“Contract staff in NSW can have their hours spread over short shifts spread over many days. For example, I am on a 60-hour contract, but it is spread over nine days when technically I could work 10 or 12-hour shifts over five or six days. But Lifeblood like to spread us over as many days as possible,” Kayla says.
“Their idea is to have more bodies on the floor at busy times. But the shift work means that part-time staff can’t find a second job because they don’t know what hours they will be working. The vast majority of the nursing staff in the donor centre are part-timers, and don’t have the option to work full-time, even though many would like more hours.”
In a short period of time Lifeblood members have put together an impressive statewide branch structure.
AT LIFEBLOOD“We are getting more members joining our union and joining our Zoom meetings.”
KAYLA WIPITI, BRANCH SECRETARY
“We formed a branch executive team, and because we are a large branch - we have witnessed a whopping 37% growth in our total membership since October 2022 – we have a very large number of delegates.
“We have three branch delegates: myself from the metropolitan region, and a branch president, Kelly Costello, who is from the Lismore donor centre, and Mary Marell from the Wollongong centre who is also the vice-president.
“We also have three alternate delegates, Hsi-Man Stella Lin, who is also the assistant secretary, and Kathy Taylor and Kathryn Richards, as well as 14 branch stewards from sites across regional and metro.
Kayla says the branch wants to have minimum staffing requirements and there is plenty of motivation to achieve their goals.
“Currently, our EA states there must be one RN on site for use to take collections or donations, but we want to have more than that because legally the RN can’t leave the site or go out for lunch – if they do, the centre can’t continue collections.
“We did a member survey for our log of claims and asked whether members would be prepared to undertake protected action and found that 60 per cent said ‘yes, if that's what it takes, I am ready to take action’, and a further 34 per cent said they would consider it after we’ve tried everything first.
“I don’t think something like this has happened before at Lifeblood.
“But there are many other steps we could take before we take state wide actions.” n
“I don’t think something like this has happened before at Lifeblood.”
Waterloo Wound Care Essentials
Thu 10 Aug, 9am-4pm, 6 CPD Hrs
Medicinal Cannabis Seminar for Nurses and Midwives
Fri 29 Sep, 9am-4pm, 6 CPD Hrs
Mental Health and Drug & Alcohol Nurses Seminar
Fri 13 Oct, 9am-4pm, 6 CPD Hrs
Effective Management of Consumer Consultation and Complaints
Tue 17 Oct, 9am-3pm, 5 CPD Hrs
Environmental Sustainability Seminar (rescheduled date)
Fri 3 Nov, 9am-4pm, 6 CPD Hrs
Child and Family Health Seminar
Fri 10 Nov, 9am-4pm, 6 CPD Hrs
Law, Ethics and Professional Standards in nursing and midwifery
Thu 23 Nov, 9am-4pm, 6 CPD Hrs
Batemans Bay
The Deteriorating Patient
Wed 13 Sep, 9am-4pm, 6 CPD Hrs
Please note: 2 working days’ notice is required for course cancellations. Read the full Education Cancellation, Refund and Catering Policy available on the Association’s website prior to registering for courses.
Friday 15 September, 9am-4pm, 6 CPD Hours
Club Blacktown 40 Second Ave, Blacktown
Cost: Members $75 / Non-members $150
Program:
• Aged Care Reforms Update
• Work, Health and Safety in Aged Care
• Behaviour Support Plans in Aged Care
• Dementia Training Australia: Dementia Training Opportunities and the Environments Training Program
• LGBTQI+ Diversity in Aged Care
• Contemporary Legal Issues in Aged Care
Scan QR to register online now
Blacktown
Aged Care Nurses Seminar
Fri 15 Sep, 9am-4pm, 6 CPD Hrs
Newcastle
Clinical Communication and Documentation
Thu 19 Oct, 9am-4pm, 6 CPD Hrs
Wagga Wagga
Nursing and Midwifery
Professional Roadshow
Fri 17 Nov, 9am-4pm, 6 CPD Hrs
Wollongong
Medications: How we do it better
Tue 28 Nov, 9am-4pm, 6 CPD Hrs
Thursdays commencing
19 October, 10-11am
What are your career goals? What are you passionate about? In this 3-part series, Sam Eddy will help you create an intention, and vision and set goals aligned to your life purpose, without all the pressure:
Part 1: Your current life reality & core values
Part 2: Bringing your new future to life
Part 3: Goal setting, planning & taking action while staying aligned to your purpose.
Sam is a professional workplace Educator, Neuroplasticity Practitioner, and creator of the Stress Temperature workplace wellbeing model.
Friday 15 September
Program finalised! For RNs, ENs and AINs in residential, community and hospital aged care settings, across private and public sectors, or anyone with an interest in the aged care sector in NSW.
Medicinal Cannabis Seminar for Nurses and Midwives
Friday 29 September
Hear from clinicians from Australia and Canada about the successes, the barriers and the future for medicinal cannabis in Australia.
Seminar
Friday 13 October
Hear from a range of speakers, network with colleagues, from residential, community & hospital areas, across mental health and D&A sectors.
Friday 3 November
Hear from a range of speakers, network with like-minded colleagues, from residential, community and hospital settings, across private and public sectors.
Friday 10 November
Hear from a range of speakers, network with colleagues, from residential, community and hospital settings, across private and public sectors.
WAGGA WAGGA
Friday 17 November
The NSWNMA is bringing an exciting and interesting education day to Wagga Wagga! Come and hear from speakers covering a range of nursing and midwifery topics.
TIME: start at 9am and conclude around 4pm. COST
20 – 21 September
9am – 5pm
NSWNMA Office
50 O’Dea Avenue, Waterloo
Let’s get active to tackle workplace bullying and racism. Sign up for this course and learn how to make the most of your Union. Help solve workplace issues that are important to you, learn how to take bystander action to address racism and bullying and learn skills to have effective conversations challenging racism.
This course is open to all NSWNMA members and is free. You may also be eligible for free travel, overnight accommodation and pay for any missed work. Scan the QR code or go to
Well, as the stories in this edition of The Lamp amply demonstrate, it has been quite a few months of frantic activity, much good, some still-reflecting struggles, but never static. Members across the board are either reaping the benefits of years of sustained struggle and pressure, or seeking new promises to be delivered on, or making sure commitments are kept.
Obtaining an improvement in pay or working conditions is a big thing, but to make it real, new entitlements as well as longstanding ones need to be implemented and enforced. Awareness and knowledge are the first important steps in ensuring this compliance. As always, let’s help this process by looking at some of your rights at work.
How many days in a row can I be rostered to work in a public hospital?
Under Clause 4(iv) of the Public Health System Nurses’ and Midwives’ (State) Award, you cannot be rostered to work more than seven shifts in a row without you requesting or agreeing to do so. Even if you do ask or agree, you cannot work more than 10 shifts in a row.
I work in a nursing home run by Allity. What notice do they need to provide a roster?
Clause 12.1 of the Allity Enterprise Agreement (New South Wales) 2018 sets out that the roster is to be made available to employees at least 14 days before the roster period begins and displayed in a convenient place accessible to employees. The roster can be posted on a staff notice board or electronically on Allity’s intranet.
I am about to start work in a medical centre. My letter of offer states I will be covered by the NursesAward. What is the span of hours I can work, Monday to Friday?
Under Clause 13.1 of the Nurses Award, ordinary hours of work for a day worker are undertaken between 6.00 am and 6.00 pm, Monday to Friday. The shift length or ordinary hours of work per day will be a maximum of 10 hours exclusive of meal breaks.
I work in an aged care facility run by Hall and Prior. When should I have a meal break on a shift?
Based on the understanding that your workplace is covered by the Fresh Fields Aged Care (NSW) No 1 Pty Ltd, NSWNMA, ANMF NSW Branch and HSU New South Wales Branch EA 2021, Clause 36.1 states that a worker must have an unpaid meal break after five hours. However, a nurse may elect to forgo the meal break, with the consent of the employer, if they work no more than six hours in the shift.
I was injured at work, but the insurer has now sent me a letter saying they are declining my workers compensation claim. How do I respond?
You should send the Association all documents about the claim (especially the letter from the insurer) so we can have the matter referred to and reviewed by NEW Law (assuming you were a member of the Association at the time of the injury). The Association can also assist with seeking from your employer, for example, suitable duties that are consistent with any restrictions you may have in place as set out by your treating doctor.
I have worked at a nursing home operated by Uniting for four years. What notice do I need to provide before I can leave?
Clause 44.15 of the Uniting Aged Care Enterprise Agreement (NSW) 2017 sets out how to calculate the notice to be provided by a worker seeking to end their employment. As you have been employed for four years, the notice you would need to provide is three weeks.
I am on maternity leave from a public hospital. Workmates have said that some changes are being proposed in my service that might affect my job. Is the hospital required to include me in any discussion?
Under Clause 34E(i) of the Public Health System Nurses’ and Midwives’ (State) Award, if a significant change at your workplace is proposed, this should be communicated to you by the hospital, and you must be informed how any proposed change could affect your position. An opportunity for you to provide feedback must also be made available.
What is the minimum shift length when working as a casual in a Healthscope hospital?
Under Clause 24 Part II (v) of the Healthscope and NSWNMA/ ANMF – NSW Nurses’ and Midwives’ – Enterprise Agreement 2020–2024, the minimum engagement (or payment) is three (3) hours for casuals.
What break between shifts do I get under the Nurses Award?
Under Clause 13.4 of the Nurses Award, a worker is to have a break of 10 hours between the completion of one ordinary rostered shift and the commencement of the next rostered shift. By mutual agreement between the employer and worker, the 10-hour break may be reduced to eight hours.
We are having issues in our public hospital ward as to when someone should be paid if the NUM is on shift, but is unavailable to take on the management of the ward. Is there any simple framework to apply?
The payment of this allowance is dealt with under Clause 12(v) of the Public Health System Nurses’ and Midwives’ (State) Award. In short, you should receive the In-Charge allowance if the NUM is not rostered on duty or if the NUM is rostered on duty but the clinical day-to-day management of the unit is delegated to a nurse. If the NUM is on duty but not available, and has not delegated responsibility to anyone else, nurses on the ward should clarify with the NUM who carries that responsibility.
This allowance remains hotly contested in some LHDs despite the Association having a precedent case determined by the NSW IRC in 2014.
The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT.
You must currently be registered with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last 12 months of which must have been spent in NSW or the ACT.
Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and application forms are available from: www.nswnma.asn.au/education
THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR
Administration Liaison, Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au
COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER
Workshop 1: 26–28 Sept 2023
Workshop 2: 14–16 Nov 2023
Workshop 3: 5–6 March 2024
50 O’Dea Avenue, Waterloo
8-DAY COURSE IN 2023
$ $3,000 NSWNMA members $3,500 non-member Pay as you go available for for self-funding attendees. Morning tea & refreshments will be provided. BYO lunch.
Clinical Supervision is a regular, dedicated time for reflection on all aspects of professional practice. Clinical supervision aims to improve care, and support the professional development and well being of staff. Clinical Supervision is highly recommended for all nursing and midwives irrespective of their level of experience or area of work (CS Position Statement ACM, ACMHN, ACN, 2019).
This eight-day foundational training equips potential clinical supervisors with a variety of techniques and approaches to conduct quality individual and group clinical supervision.
COURSE CONTENT: The training provides clinical supervisors with an understanding of the Role Development Model of clinical supervision, the supervisor role and a framework for clinical supervision practice. The learning includes utilisation of role theory, role analysis, concretisation techniques, action-learning techniques and role training as clinical supervision interventions. Other innovative interventions such as ‘this year/next year’ are included.
• Appreciate the benefits of clinical supervision in participant’s work area
LEARNING OUTCOMES:
• Identify other models of clinical supervision and the theories informing the Role Development Model
• Understand and explore concepts and techniques used in clinical supervision
• Conduct effective individual and group clinical supervision sessions within the framework
• Demonstrated confidence and competence in applying advanced clinical supervision techniques.
CONTACT Paul Spurr, 0410 033 342 / paul@spurrcsc.com
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until
Julian Brendon Towney was born on 23 May 1964 in Wellington NSW. He was the 4th child and second son of Gwen and Frank Towney.
Brendon attended primary schools in Wellington and Sydney, before heading to St Stanislaus College in Bathurst for his secondary education.
Brendon was a highly intelligent student who did very well throughout his high school years. He had a remarkable memory and a lifelong interest in the sciences and the solar system.
In 1994 Brendon graduated from CSU as an RN. Brendon worked in hospitals across Australia for 29 years. He even travelled to Carnarvon, around ten hours drive north of Perth, and worked for a year, experiencing a different kind of work and life. Brendon’s most recent tenure was with the Gosford and Wyong Mental Health
Inpatients Units where he worked for 18 years.
Brendon loved to travel. He made five trips to Europe and three to the US, with trips to the Asian regions and New Zealand as well. While in New Zealand, he did bungee jumping on a number of occasions.
Brendon started playing the recorder, performing at school assembly, from early primary school, in response to his asthma. Eventually, one of Brendon’s greatest passions became classical music. He played in various orchestras over the years, including the Strathfield Symphony Orchestra, with whom Brendon toured Europe. He played viola, tuba, and trombone at orchestra level.
Brendon will be dearly missed by his family and friends. His family would like to thank all who offered their condolences and kind words following Brendon’s passing.
Business groups mobilise against the Secure Jobs, Better Pay Act , which came into force in June.
Employer groups have spent millions of dollars on a national advertising campaign against new IR laws that ensure labour hire workers are paid the same as employees doing the same job where they work.
The new laws are the implementation of a promise the ALP made in the lead-up to the 2022 federal election.
Workplace Relations Minister, Tony Burke, said he was surprised the advertising campaign “continued to rail against something we’re not doing”.
“The term ‘labour-hire loophole’ describes exactly what we’re doing: closing a loophole in which labour hire is deliberately being used to undercut agreed pay and conditions.”
New research by the ACTU has found that:
• about 600,000 workers, or 3.5 to 4.5 per cent of the workforce, are employed through labour hire
• about 81 per cent of labour-hire workers work full-time hours yet they do not have full-time jobs
• some 84 per cent of labour hire workers do not have paid leave and most have no guaranteed minimum hours.
ACTU president, Michele O’Neil, said some big businesses are using the loopholes to get out of paying proper wages and entitlements, such as sick leave and annual leave.
“Businesses are upset they have been exposed manipulating the system to cut wages,” she said.
Gambling harm is profound. It is not just financial, it is also social. It impacts mental health, leads to other health issues, and too often it leads to suicide, argues a leading campaigner.
The parallels with big tobacco and gambling are chilling, said Reverend Tim Costello AO.
“They are both predatory industries –industries that knowingly sell harmful products. They invest massive sums to sell and market addictive products.
“Most disturbingly, both tobacco and gambling companies invest huge sums to develop new, addictive products, designed to get young people hooked,” he wrote in the online journal Pearls and Irritations.
Costello argues that governments should treat gambling as a public health issue in the same way they do tobacco.
“We successfully applied a public health approach, banned advertising, introduced plain-paper packaging, and funded research and public education. Eventually, the number of people smoking dramatically reduced and countless lives have been saved as a result,” he said.
“When we look at gambling harm today and the virtually unlimited and unrestricted marketing of gambling, it is as if we have learnt nothing from history.”
Gambling in Australia, he said, “is normalised and celebrated, which has led to the highest levels of gambling losses per capita in the world”.
Costello said the federal government should establish a unit in Health and spearhead the development of a comprehensive national strategy for gambling that encompasses prevention, awareness and education, treatment and research.
‘Businesses are upset they have been exposed manipulating the system to cut wages.’
— ACTU president, Michele O’Neil
‘The parallels with big tobacco and gambling are chilling.’
— Reverend Tim Costello AO
More than 2.75 million workers to benefit, but the increase is still below the inflation rate.
The Fair Work Commission’s annual wage review decision increased minimum wages to $882.80 per week, or $23.23 per hour.
The increase is about midway between the 3.8 per cent called for by business groups and the 7 per cent sought by the ACTU.
Fair Work Commission president, Adam Hatcher, said the previous year’s 5.2 per cent minimum wage increase had affected about one in four workers whose wages made up 11 per cent of the national total, and had not contributed to a wage-price spiral.
ACTU secretary, Sally McManus, said this year’s increase would “really help millions of working people to stay afloat”.
“It is a critical increase during this cost-of-living crisis,” she said.
“As it does every year, big business pushed hard for a cut that would see Australia’s lowest paid workers go backwards by at least $1350 a year.
“We call on the Reserve Bank not to raise interest rates again… as this would obliterate the raise low-paid workers have just gained.”
The employment minister, Tony Burke, welcomed the commission’s decision as “the best decision for workers we’ve ever had”.
He said it was “dreadful” some would interpret the wage increase as elevating the risk of higher interest rates.
British five-year-olds are getting shorter and experts attribute the trend to austerity policies that have impoverished lives. Previous studies had shown there was a slower increase in the average height of British five-year-olds after 1985. But recent research has shown that since the mid-2010s, things have got dramatically worse and the average height of five-year-olds has gone down.
“The link between height, nutrition and social circumstances can already be seen in childhood. There is a neat gradient – the greater the deprivation, the shorter the child,” said Prof. Michael Marmot, Director of the Institute of Health Equity at University College London.
Marmot said “it is really bad to be poor in Britain” and that health inequalities have increased during years of austerity. Health among the poorest people is in a state of decline, he added.
“Incomes of the poorest 10 per cent are way below those in other European countries. It means that people of low income cannot afford the basics of food, shelter and home heating.
“Both Conservatives and Labour in Britain put high priority on economic growth. I would rather see a reduction in health inequalities and growth in the height of five-year-old children. That way we will know that we have an economy that is really delivering for the health and wellbeing of all.”
‘It is a critical increase during this cost-of-living crisis.’
— ACTU secretary Sally McManus
‘Both Conservatives and Labour in Britain put high priority on economic growth. I would rather see growth in the height of five-year-old children.’
— Professor Michael Marmot
The Australian National Audit Office slams the Morrison government for mismanagement of health grants.
A review by the Australian National Audit Office (ANAO) found that a $2 billion Morrison government health and hospitals funding program was “ineffective and fell short of ethical requirements”, the Sydney Morning Herald (SMH) reported.
The ANAO found grants were awarded to health projects despite being inconsistent with the rules for awarding Commonwealth funds, and nearly half of all the projects that were funded were in marginal seats.
The SMH said the Health Department “was reduced to monitoring the media to keep track of which projects had been selected for funding by the former Coalition government”.
Independent MP Helen Haines told the SMH the “report shows an appalling abuse of public trust. I am shocked that even our health care could be pork barrelled”.
“This could be sports rorts for hospitals,” she said, referring to a $100 million sports funding program that was also subject to a scathing ANAO review in 2020.
Funding highlighted as problematic by the report included a $4 million grant to the Esther Foundation, which provided counselling services and is now in voluntary administration, a $5 million grant to the Lord Somers Camp, a sporting organisation in Victoria, and a $25 million project to expand the Peel Health Campus in Western Australia in Liberal MP Andrew Hastie’s seat.
A study warns we have exceeded seven of the eight variables for maintaining a healthy and just planet. In 2009, a team of renowned environmental scientists published an “extraordinarily influential” article in Nature magazine arguing that planet-altering human activities could be assembled into nine groups.
Thresholds were calculated for most of them, beyond which the result could spell danger for the planet and its people. At the time the scientists concluded that humanity has crossed three of these nine “planetary boundaries”.
An update on this research by the international scientist group Earth Commission has found that seven out of eight of the original thresholds have now been crossed.
The eight “planetary boundaries” are climate, natural ecosystem area, ecosystem functional integrity, surface water, groundwater, nitrogen, phosphorus, and aerosols.
Adding environmental justice to this list has led the authors to advocate that global warming should be limited to 1°C above pre-industrial levels. This is lower than the 1.5°C target agreed at the 2015 Paris climate conference.
The authors reason that keeping to 1.5°C might well enable the world’s more-affluent people to
protect themselves, but it would create significant harm for the most vulnerable.
“Exceeding these boundaries is like entering completely unknown territory with conditions where we don’t know how the planet will behave,” one of the researchers, Daniel Ospina, told the Spanish newspaper El País.
‘I am shocked that even our healthcare could be pork barrelled’
— Helen Haines, Independent MP
'Exceeding these boundaries is like entering completely unknown territory with conditions where we don’t know how the planet will behave.'
— Daniel Ospina, researcher
Access to online CPD
FREE for NSWNMA members and student members
Meeting your Continuing Professional Development (CPD) obligations is now even easier with this great new benefit for NSWNMA members. As a financial member you have access to over 200 CPD modules – all part of your Association membership.
FREE access to over 200 CPD modules online
Highly visual and interactive modules you can do at your own pace
New modules added regularly
Your own personalised ePortfolio and CPD tracker so you can provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually.
for NSWNMA members LOGGING ON
nswnma.info/ilearn
users create a ONE-TIME login to Member Central
receive access to hundreds of FREE CPD hours
ACROSS
1. An obstruction of a blood vessel in the lungs (9.8)
9. Reappraisal, reassessment (11)
12. Overtake (7)
13. Belonging to us (3)
14. Decipherer (7)
15. A mixture of gases required for breathing (3)
16. Clothing (7)
18. Containing a common line; coaxial (9)
20. Having a lean, slightly muscular body build (11)
22. The smallest unit of DNA at which a mutation can occur (5)
24. An instrument for the examination of the interior of a tubular or hollow organ (9)
27. An abnormal group of red blood cells adhering together like a pile of coins (7)
28. The act of cooling or reducing fever (13)
30. Symbol for normal intraocular tension (1.1)
31. A form of magnetic resonance imaging of the brain that registers blood flow to functioning areas of the brain (1.1.1.1)
32. Replacements or repairs of tissues or organs lost through damage (13)
36. Relating to the upper and lower jaws (17)
DOWN
1. May cause temporary hearing loss (10.7)
2. Senile lentigo (5.4)
3. Lubricated (5)
4. Lacking blood vessels (9)
5. One of the steroids of the cortex of the suprarenal gland that influence salt metabolism (17)
6. Japanese art of paper folding (7)
7. Copy, simulate (7)
8. Antipsychotic agent (5.12)
10. Containing iodine (5)
11. Order Visibility Exchange (1.1.1)
17. A disappearance of a disease as a result of treatment (9)
19. Urethral inflammation (1.1.1)
21. Gradation of a color; tint (3)
22. Grieve (5)
23. An exercise device (9)
25. To remove moisture or mist from a surface (5)
26. The part of an organ where the nerves and vessels enter and leave (5)
29. Nearly closed cavities or chambers (5)
33. Echo-planar imaging (1.1.1)
34. An inflammatory complication of leprosy (1.1.1)
35. Weep, cry (3)
The Association’s professional team answer your questions about professional issues, your rights and responsibilities.
I am an EN working in aged care. I have heard there is no funding for ENs in aged care anymore – is this true?
ENs make up a vital part of the clinical workforce and although minutes of care provided by ENs cannot currently be counted towards RN-specific care minutes, the direct care they provide to residents is included in the total care minutes. The federal government has asked providers to report separately on their EN care minutes. These minutes will be published on My Aged Care as part of the overall Star Rating from October 2023. This shows that they see the EN role as an important part of the aged care workforce.
There was an incident at work where a patient came in with cuts and wounds. During the assessment, the patient disclosed the weapon used to inflict the wounds and who the attacker may have been. The police have attended and asked me to provide a statement. What do I do; what will happen next; and can the NSWNMA help?
If you are ever asked to provide a statement or be a witness in a criminal case, please call the NSWNMA, before providing a statement, to speak to one of the legal officers for information and advice so you can better understand the process and what might happen next.
A statement is a formal written document outlining what you saw, heard, and did. At the start
it states that you must be telling the truth in the statement, and it requires your signature before a witness.
Often the police will ask you to give them a statement in the immediate aftermath of an incident. You are entitled to take the time you need, including to seek advice or review any documents you consider will assist you with your recollection, before you provide a statement. You cannot be forced to provide a statement or forced to sign one you don’t agree with.
Always be professional and polite to the police and let them know that you wish to seek advice. You are entitled to seek independent legal advice from the NSWNMA before you provide a statement.
I was stopped for a random breath test and was found to be driving with a mid-range prescribed concentration of alcohol. I must go to court in two weeks’ time. This isn’t related to my registration. How can the NSWSNMA help me?
Under the Nursing and Midwifery Board of Australia (NMBA) Standards for Practice and Codes of Conduct, your conduct in your personal life can affect your professional life and your registration.
As a registered health practitioner, if you are charged, found guilty or convicted of a criminal offence, including a serious driving offence with a possible penalty of 12 months’ imprisonment, there are mandatory notification requirements to the Australian Health Practitioner Regulation Agency (AHPRA) within seven days. This is a very short timeframe at a stressful time.
We recommend you contact the NSWNMA as soon as possible to speak to one of our legal officers, who are very experienced and can assist you to meet your reporting obligations. They can also advise, assist and represent you through any disciplinary process that may follow. Having someone on your side to help you navigate this process can make all the difference.
Our legal officers can also advise you on any declaration you may be required to make at registration renewal.
I have COVID-19 and I probably caught it at work. My employer says I can’t get workers compensation because I wear PPE at work, so I probably caught COVID on the bus and can’t prove I caught it at work. Is this right?
Healthcare workers including nurses and midwives in NSW do not have to prove the source of a COVID-19 infection to make a workers compensation claim. Nurses and midwives and all other healthcare workers, permanent or casual, who are diagnosed with COVID-19 are presumed to have contracted the virus in the course of their employment.
If you test positive to COVID-19, you should notify your employer immediately. A positive RAT test is sufficient evidence to submit a claim without confirming by PCR. A Certificate of Capacity will be required from your doctor and may be assessed and provided through Telehealth.
For further information please review The Lamp Professional Issues COVID-19 (https:// thelamp.com.au/professionalissues/covid19/latest-guidelinesfor-nurses-covid-19/)
If you would like some more advice or your claim has been declined, please contact the Association (www.nswnma.asn. au/about-us/contact).
I am frequently asked to do overtime due to short staffing and I find it hard to say no as I don’t have carer responsibilities like most of my colleagues. I am exhausted and thinking about reducing my permanent hours to manage my exhaustion –what should I do?
Your employer has an obligation to ensure your safety at work and this includes managing risks of fatigue. They cannot require you to do unreasonable overtime that creates risks to your physical or mental health. Raise your concerns through the normal channels in your workplace. Be sure to do this in writing.
Additionally, nurses and midwives have obligations to manage their fatigue under the Work Health & Safety (WHS) Act 2011 No. 10 (NSW) and the Nursing & Midwifery Board of Australia’s Codes of Conduct. All nurses and midwives can refuse unreasonable overtime that creates a risk to health and safety. Public sector nurses have this inclusion detailed in their award. After 17–19 hours without sleep, performance effects in the workplace are the equivalent to those of someone with a 0.5 blood alcohol level.
As a member of NSWNMA, you can access incredible offers and discounts which can save you over $2,000 each year. You can:
Instantly access savings on groceries with Coles and Woolworths.
Save on whitegoods, technology and electronics with our strategic partners.
To start accessing your rewards, login at:
online.nswnma.asn.au
Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. In honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes.
Activism • Campaigning • Advocacy
The scholarship covers fees for an approved course promoting activism and the development of campaigning skills or public advocacy, including ongoing financial support for reasonable costs associated with campaigning for a period of one year, up to a maximum of $5,000.
NSWNMA Branch Officials or highly active members who can demonstrate leadership qualities are encouraged to apply. Successful recipients are required to report back to Committee of Delegates (COD) at the end of the scholarship period.
Applications open 1 July, closing 30 September 2023
The mission of AJAN is to provide a forum to showcase and promote a wide variety of original research and scholarly work, to inform and empower nurses, midwives and other healthcare professionals to improve the health and wellbeing of all communities and to be prepared for the future.
Australia 2020
Advanced practice is a term used across health professions, including nursing, with a variety of meanings attached to the term. Over recent years, there has been an increase in job titles including the term ‘advanced’. This has led to confusion about what the term ‘advanced’ signifies in a title, what being ‘advanced’ means in the practice of nursing and how the profession distinguishes these roles from other nursing roles.
To support development of these roles to address clinical service gaps, the health system needs clarity as to what the term ‘advanced nursing practice’ describes in the Australian context. Also, a clear understanding of what constitutes advanced nursing practice will assist in enabling nurses to develop the necessary skills and attributes required to attain endorsement as a nurse practitioner –the only regulated advanced nursing practice role in Australia.
The purpose of these guidelines is to reduce the confusion that often exists about the scope of advanced nursing practice roles and provide greater clarity and understanding for nurses, employers, consumers and policy makers. Each jurisdiction may have a different way they develop and implement advanced nursing practice roles. These guidelines will also assist in providing national consistency.
https://www.health.gov.au/sites/default/ files/documents/2020/10/advancednursing-practice-guidelines-for-theaustralian-context.pdf
Where are the practising nurse anaesthetists in Australia? Exploring an advanced practice role for anaesthesia nurses
Michaels, Lucy and Foran, Paula (2022)
The perioperative environment has seen the implementation of the
perioperative nurse surgical assistant as an advanced practice nursing role for the instrument nurse; however, there is currently no recognised equivalent role for the anaesthesia nurse.
Anaesthesia nurses complete postgraduate qualifications and learn advanced clinical skills, and yet the authoritative body for perioperative nurses, the Australian College of Perioperative Nurses, does not define a specific role for advanced practice nursing in anaesthesia.
Career advancement for the anaesthesia nurse focuses on education and management roles, which are a distinct deviation from advanced clinical practice. A new role should be developed to allow the advanced practice nurse in anaesthesia to be recognised and their skills used in Australian operating rooms.
https://www.journal.acorn.org.au/jpn/ vol35/iss1/5/
Advanced Practice: Thoughts behind the concept
Caroline Brady Nevin
To provide the role and function of an advanced practitioner, nurses must have a clear understanding of what constitutes advanced practice. No precise definition of ‘advanced practice’ is evident from current literature. However, with a variety of perceptions of advanced practice from the US, Australia and the UK taken on board, it is possible to identify the current meanings of advanced practice. While this may provide some convenience and common understanding, it can also precipitate confusion. The fact we live and work in a country that is culturally different to those mentioned above receives scant recognition.
https://www.inmo.ie/tempDocs/ advanced_prac_jul_aug06.pdf
Independent report on the regulation of advanced practice in nursing and midwifery
Palmer, Julian & Vaughan, Nuffield Trust
Nurses and midwives are increasingly taking on more complex, autonomous and expert roles, commonly referred to as ‘advanced practice’. These roles have been developed over time for a range of clinical, operational, financial, resourcing and professional reasons and are intended to benefit patients, practitioners and health and social care. The policy across the four countries of the United Kingdom (UK) appears to be to increase the number of advanced nurse roles. All midwives are autonomous at the point of registration and ‘advanced practice’ in midwifery remains at a far smaller scale, although there have been some recent efforts to more clearly establish such roles.
The regulation of health and social care professions is intended to protect the public from the risk of harm and maintain public confidence. In the UK, nurses and midwives are regulated by the Nursing & Midwifery Council (NMC). Currently, there is no specific additional regulation covering advanced practice. As a result, nurses and midwives working in advanced practice are responsible for ensuring they work within existing regulatory frameworks. Meanwhile, employers are responsible for assuring, for example, the suitability of an individual’s qualifications, along with previous experience of undertaking advanced practice roles. There are also other processes for providing assurances around advanced practice, including through the commissioning and (non-mandatory) accreditation of educational programs and via credentialling (formal recognition of professionals’ competencies) by some professional bodies.
https://www.nuffieldtrust.org.uk/sites/ default/files/2023-05/Advanced%20 practice%20report%20FINAL%5B69%5D. pdf
The Australian Journal of Advanced Nursing (AJAN) is the peer-reviewed scholarly journal of the Australian Nursing and Midwifery Federation (ANMF).
The variable hours that many nurses and midwives work can make it tough to get enough sleep. While it may seem like losing sleep is not a big deal, sleep deprivation can have a range of negative effects that go way beyond fatigue or drowsiness.
‘Sleep hygiene’ refers to the strategies you put in place to ensure you develop and maintain good sleep habits, allowing you to have enough quality sleep.
Some basic strategies for ensuring a good night’s sleep for shift workers can include:
• trying to go to bed at the same time every day and getting up at the same time too
• turning off all technology at least one hour before bedtime, including mobile phones and television
• creating a comfortable room and bed to sleep in; dark and quiet rooms promote sleep
• avoiding caffeine four to six hours before going to sleep
• avoiding alcohol, cigarettes and sleeping pills before bed
• getting fresh air into your bedroom
• where possible, developing a sleep routine prior to bedtime.
If you are on a late shift, try to have a full sleep before going to work. This is better than sleeping earlier in the day so you’re tired before your shift begins. If
this is not possible, taking a nap before going to work may help. A maximum 15-minute nap is best, then a short postnap activity such as a five-minute walk will help you to wake up properly before resuming other activities.
When you are trying to keep up with the demands of a busy schedule, cutting back on sleep may feel like your only option. But over time, even minimal sleep loss can have an impact on your physical health, mood, energy, mental sharpness, and ability to handle stress. Lack of sleep can affect your judgement, coordination and reaction times. Sleeping loss impairs judgement and performance: 17 hours without sleep is as dangerous as having a blood alcohol content of 0.05%. The recommended amount of sleep for adults is seven to nine hours per 24-hour period.
• fatigue, lethargy, lack of motivation
• moodiness, irritability, increased risk of depression
• relationship problems
• impaired learning and concentration, memory problems
• reduced creativity and problemsolving skills, difficulty making decisions
• inability to cope with stress and difficulty managing emotions
• premature ageing of the skin
• weakened immune system, frequent colds and infections
• weight gain
• impaired motor skills and increased risk of accidents
• increased risk of serious health problems including stroke, diabetes, high blood pressure, heart disease, Alzheimer’s disease, and certain cancers.
If you are struggling with any of these, you might want to talk to your general practitioner as a starting point.
Nurse & Midwife Support provides free and confidential support 24/7 to nurses, midwives and students Australian wide. If you would like to speak to someone call 1800 667 877.
Recruit a new member and go into the draw to win a $1,500 WORLDWIDE TRAVEL
The NSWNMA has partnered with ubookdirect to reward you!
Recruit a new member and you could win a $1,500 travel voucher that can be used on accommodation anywhere around the world. Every member you sign up over the year gives you an entry in the draw!
Ubookdirect offers all NSWNMA members discounted rates on 1000s of hotels Australia wide and all around the world. Never pay full price for a holiday again. Visit ubookdirect.com/partner/nswnma or call 1300 959 550.
The NSWNMA will cover return flights for two from Sydney to the value of $3,000.
RECRUITERS NOTE: Join online at www.nswnma.asn.au
If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form, so you will be entered in the draw.
